THE VALUE IN BENEFITS AND NONSTOP WELLNESS PILOT

In an effort to provide cost-effective, ACA-compliant health care plans, Community Health Ventures (CHV), business development affiliate of the National Association of Community Health Centers (NACHC), is piloting a partial self-funded health insurance product – Nonstop Wellness – with Nonstop Administration & Insurance Services. This plan is built from existing group health insurance and offers an immediate reduction in premiums without having to change carriers, unless desired – and better benefits for employee recruitment and retention.

As part of this pilot, CHV will invite community health centers to participate with the hope of expanding the program later in 2016.

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Who is Nonstop?

Nonstop Wellness works to reengineer the traditional healthcare approach, shifting the current paradigm so that community health centers – and their employees – see health insurance as an asset emphasizing wellness, not a burden of increasing costs or maintaining ACA compliance.

Nonstop believes that no one should be without quality, affordable healthcare that emphasizes prevention and solutions. It has developed a transparent system, innovative technology and an experienced team to back up that belief.

To support nonprofit growth and sustainability, Nonstop provides high-quality, affordable employer-sponsored healthcare for the organizations that serve our communities. Its approach to partially self-funded healthcare provides a baseline savings of 12.5%, plus platinum-level benefits and significantly reduced out-of-pocket costs for staff. For both employers and employees the direct savings, as well as improved benefits, result in a better long-term healthcare and wellness experience.

How It Works

By utilizing the group health insurance model, the Nonstop Wellness program helps health centers identify and purchase less expensive, high deductible health care plans (HDHP), including any offered by the health center’s current carrier. Premium savings resulting from the purchase of a HDHP starts at 12.5% for CHCs already offering gold and platinum level plans with at least 50 members on health benefits.

Nonstop then creates a reserve pool to cover the cost of routine health maintenance up to the deductible amount of the chosen HDHP per organization. The Nonstop Wellness program includes administration of the plan and claims management for all eligible transactions with the chosen carrier.

Lastly, because most employees utilize just 50%-75% of premiums paid into a fully-insured plan, the probability of money being returned to the health center from the reserve pool is very high.

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Why Join

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Guaranteed premium savings

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ACA-compliant plans
(ability to retain current carrier)

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Administration of all
claims for health
maintenance

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Opportunity for additional
savings through return of
reserve funds

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Enhanced employee
benefit

(including alternative
and complementary care
at no additional cost in
some markets)

GUARANTEED PREMIUM SAVINGS

Nonstop will analyze a health center’s risk for moving to a partially self-insured plan and assure a baseline savings of at least 12.5% when compared to a fully funded platinum or gold plan.

CLAIM ADMINISTRATION AND CUSTOMIZED BENEFITS

A significant benefit to partially self-insured plans is the savings, but equally important is the limited financial risk. This lower financial risk is the result of the management of many administrative functions through a high deductible health care plan (HDHP). In fact, over 90% of all claims are for transactions under $500. Nonstop will work with the HDHP carrier to adjudicate claims and manage all claims that fall below the deductible.

ENHANCED EMPLOYEE BENEFIT

On average, healthcare costs account for over 20% of employee wages. By moving to a high deductible health care plan (HDHP) with a reserve pool, the Nonstop Wellness program can lower premiums and eliminate the deductibles, copayments and coinsurance typically found in fully funded plans. Because of the savings, employees’ real wages actually rise, which gives footing for organizations to retain and employ top talent.

ACA-COMPLIANT PLANS

Nonstop will research which high deductible health care plans (HDHP) are available to the health center, beginning with their current carrier since most carriers offer HDHP plans. This accounts for the majority of Nonstop Wellness’s guaranteed premium savings.

Nonstop will also analyze the high/medium/low averages for employee use of the health care plan and establish a fiduciary account of reserve funds to pay for employee health maintenance claims. This assures cost-certainty with a “pay-as-used” model and maintains ACA compliance.

OPPORTUNITY FOR ADDITIONAL SAVINGS

In a traditional or fully funded health plan, employees use an average of 50%-70% of their premium dollars. Unfortunately, neither the employer nor employee ever sees a return of those unused premium payments. However, Nonstop Wellness delivers a “pay-for-use” model that allows a quarterly return to health centers from the reserve pool.

Essentially, Nonstop analyzes employee healthcare use and, through its proprietary predictive software, creates a reserve pool that will cover the costs of employee health maintenance and effectively manage the health center’s financial risk.

Case Studies

Our goal is simple: to reduce the inflationary costs of healthcare for CHC’s by changing how it’s delivered

Westside Community Services

San Francisco, CA // 73 Enrollees

Nonstop’s commitment to community health centers is apparent in everything they do, from the cost savings to administrative support to customer service. The team at Nonstop has been a true partner with Westside through every step of the process, and now our employees receive much improved benefits at a fraction of the cost to both them and our organization.
– Shalece Booker, COO

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Rogue Community Health

Medford, OR // 109 Enrollees

By providing improved benefits at a much lower cost and with no out-of-pocket expenses, both RCH and our staff will have more opportunities to use valuable dollars in the areas where they will have the most impact. For RCH that means expanded patient access and staff development, and for employees that means more money each month for family, home and other life expenses.
– William North, CEO

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East Valley Community Health Center

West Covina, CA // 178 Enrollees

Nonstop Wellness allows us to provide a comprehensive, high-quality healthcare plan at an affordable price to East Valley employees. At the same time, we are able to save valuable administrative time and operating funds, which can be re-directed to areas of need within our communities.
– Linda Chau, HR director

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Lifelong Medical Care

Berkeley, CA // 405 Enrollees

With Nonstop Wellness not only will Lifelong employees and their families have access to vastly improved benefits at significantly reduced costs, but the organizational savings means more money and opportunities to expand on the quality care we already provide our clients.
– Kanwar Singh, CFO

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Learn more about Nonstop Wellness and partial self-insurance for nonprofits